Man with multiple thyroid nodules and need guidance

Hello,

I had a CT during 5/2012 for a small mass on the back right preocciptal area of my neck (i.e., mid back near spine just below base of my head) the mass was 3x7x9 mm. I saw numerous doctors including 4 ENTS that refuse to biopsy the mass even though I have been experiencing neck pain and pressure in my right ear. Since then, my new general practioner looked at the CT paperwork and also found that the CT found multiple hypodensities on my thyroid. I have since had an ultrasound as of 1/10/2013 and the report said the following:

Right thyroid 1.9x5.6x1.7 cm w/ at least 4 discrete subcentimeter lesions in the right thyroid lobe. Some have songraphic features consistent with cysts while some are solid nodules. There is also a 0.9x0.7x0.6 cm hypo to anechoic focus in the mid pole of the right thyroid lobe which may represent a complex septated cyst versus 2 adjacent cysts. the left thyroid lobe measures 1.9 x 5.2 x 1.3 cm with subcentimeter solid nodules present. the thyroid isthmus is 0.4 cm in diameter. No dominant lesions present, but followup imaging in 1 year is recommended.

I am 29 years old, male, and I have had multiple xrays for dentistry and now this CT. I have an MRI scheduled, and my doctor feels that I do not need additional bloodwork because my tests in July were normal - it is now January... My previous practicioner was not working for me, so I have a new general doctor, but he feels since my old doctor ran bloodwork in July, additional work is not necessary. Second, should I be concerned about this being cancer? I know that men that develop nodules are at higher risk of malignancy in nodules. Further, I am going back to my ENT, but I am not sure if I should see an endocrinologist instead... Does anyone have any pointers? I have the mass on the back of my neck now too that is causing issues and the thyroid feels like a small pill caught in my throat... I am extremely scared and anxious...

Thanks,

Mike

[S. Kaul, MD]

Hey Mike!

The mass at the back of the neck are likely to be lymphnodes or sebaceous cysts and unlikely to be related to the thyroid. Most of the thyroid nodules described are cystic while a few are solid. One may consider getting uptake studies done to specifically classify the nature of the nodules. Alternative these may be followed up over a period of time and if they show any signs of malignancy, further testing may be done. It would be best to discuss the situation and the management plan in detail with your treating doctor.
Hope this is helpful.

Take care!

[tam340]

Hi Mike,

This may seem unrelated, but 2 years ago I went to my dermatologist for a mole that just sprang up. on my face.  She looked at it and said it was just a mole, no worries.  The following year at my GP yearly visit I mentioned that my mole was now bleeding once in a while.  He sent me to another dermatologist,  Again, it was declared "just a mole" and the bleeding was most likely due to me knocking it when I washed my face.  I insisted on a biopsy.  It was cancer.  

The moral of the story is you need to be your own best advocate.  If you are worried then push the issue.

Best of luck,

Tam